More hygienists are graduating than leaving, yet 91% of dentists trying to hire one call it very or extremely hard. Dr. James Younger on what changed, three things to do about it, and six changes coming at your front desk.
Short answer: Hygienists haven’t left the profession. Demand jumped: CDCP enrollment went from 3.6 million to 6.5 million in about a year, and nobody added hygienists at that pace. Canadian practices now have 7,200 open hygienist and assistant positions. Protect your recall patients first, move assistant-eligible work off your hygienists’ schedules, and separate new-patient exams from hygiene time.
Canadian practices have 7,200 open hygienist and assistant positions, and 6.5 million new CDCP patients to look after. That is from the Canadian Dental Association’s assessment in September 2026.
In New Brunswick, the dental society says a hygiene appointment is now booking nine to ten months out.
And yet more hygienists are graduating than leaving. The CDHA says so for Canada. In the US, 2025 was the largest graduating class on record, and 91% of dentists trying to hire a hygienist still call it very or extremely hard.
So where is everyone?
More hygienists than ever. And 6.5 million more patients.
It is tempting to say hygienists left the profession. The numbers do not show that.
What changed is the other side of the ledger. The CDCP started in May 2024 with seniors. When adults 18 to 64 joined in June 2025, enrollment went from 3.6 million to 6.5 million in about a year. About four million of those patients have already been in a chair. Every one of them needs hygiene time.
As a practicing dentist, I think that is good news for patients. But the plan designed the demand and assumed the supply. Nobody added hygienists at the pace it added patients, and you cannot train one in a year.
Governments are catching up. Ontario now lets hygienists licensed in other provinces start work while their registration completes. Ottawa is putting $35 million into training programs. That helps in 2028. It does not help your schedule this fall.
So this is not a story about people who will not work. Yes, some hygienists prefer part-time and flexibility over full time. You can hire that way too. But mostly this is a math problem, and it lands on your hygiene column first.
What to do about it
- Protect your recall patients first. Book the next hygiene visit before the patient leaves, and hold those slots. A full recall schedule is the one thing a nine-month wait cannot take from you.
- Put hygienist hours where only a hygienist will do. Check what your province lets dental assistants do, such as polishing, fluoride and radiographs, and move that work. It frees chair time without hiring anyone.
- Separate the new-patient exam from hygiene time. A new patient should not wait nine months to be seen because the cleaning is booked out. See them, plan the care, then schedule the hygiene.
Heads up: six things coming at your front desk
As of October 2026.
1. Some of your CDCP patients lost coverage and do not know it. (Canada) Anyone who missed the June 1 renewal was dropped on June 30 and has to reapply. Do this: check eligibility when you confirm the appointment, not when the patient is in the chair.
2. Two student plans changed carriers on September 1. (Canada) Alumo and GuardMe claims now go to TELUS AdjudiCare, carrier ID 000034. Do this: update the carrier in your practice software today, or the next student claim bounces.
3. About half of CDCP preauthorizations are being denied. (Canada) The CDA also found 59% of patients believe the plan is free. Do this: send full documentation with every preauthorization, and explain the co-pay before the patient sits down.
4. Alberta still has no date for leaving the CDCP. (Alberta) 306,000 Albertans stay on the federal plan through June 30, 2027 while the province builds its own. Do this: plan your 2027 hygiene schedule both ways.
5. In BC, every licensed hygienist can now own a private practice. (BC) It has been true since April 1, 2026 under the new Health Professions and Occupations Act. New York and Utah passed similar laws in 2026. Do this: ask your hygienists what would keep them, before someone else offers it.
6. Sixteen US states passed 30 dental insurance laws in 2026. (US) They cover loss ratios, virtual credit card fees, network leasing and downcoding, and 35% of dentists are considering dropping a network. Do this: check what changed in your state before you renew a contract.
One last thing
October is Dental Hygiene Month in the US, and Ontario marks its own Dental Hygiene Week in October. Thank your hygienists out loud. It costs nothing and they notice.
Frequently asked questions
Yes. The Canadian Dental Association reported 7,200 open hygienist and assistant positions in Canadian practices in 2026, and in New Brunswick hygiene appointments are booking nine to ten months out. The shortage is mostly a demand problem: hygienists are not leaving the profession faster than they graduate.
Demand grew faster than supply. The Canadian Dental Care Plan grew from 3.6 million to 6.5 million enrolled people in about a year after adults 18 to 64 joined in June 2025, and about four million have already been in a dental chair. Hygienists cannot be trained in a year, so new training funding mostly helps from 2028 on.
Book each patient’s next recall visit before they leave and hold those slots, move work your province lets dental assistants do (such as polishing, fluoride and radiographs) off hygienist schedules, and see new patients for an exam before their hygiene visit so they are not waiting months to be seen. Temp hygienists can cover gaps while you hire.
Yes. Since April 1, 2026, every licensed dental hygienist in British Columbia can own a private practice under the Health Professions and Occupations Act.
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